K-wire implants for fractures

ABSTRACT

A variety of K-wires with imbedded plates are disclosed that allow for the plate in K-wire to be secured to the bone after insertion. Further, a donut shaped washer for capturing and securing the K-wire is disclosed. Also, a screw with a channel is disclosed that has a head shaped to capture and secure the K-wire. Finally, embodiments of a slotted washer are disclosed that captures and secures the K-wire.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims benefit to U.S. Provisional Patent ApplicationNo. 63/032,249 filed on May 29, 2020, the contents of which are herebyincorporated by reference for all purposes as if fully set forth herein.

TECHNICAL FIELD

Various exemplary embodiments disclosed herein relate generally to aK-wire implants for fractures.

BACKGROUND

K-wires are sharpened, smooth pins that are widely used in orthopedicsurgery as well as other types of surgery. They are often made ofstainless steel. K-wires come in a variety of sizes and are used to holdbone fragments together. K-wires may be driven into the bone (sometimesthrough the skin) using a power or hand drill.

SUMMARY

A summary of various exemplary embodiments is presented below. Somesimplifications and omissions may be made in the following summary,which is intended to highlight and introduce some aspects of the variousexemplary embodiments, but not to limit the scope of the invention.Detailed descriptions of an exemplary embodiment adequate to allow thoseof ordinary skill in the art to make and use the inventive concepts willfollow in later sections.

Various embodiments relate to a K-wire with an integrated plate,including: a plate with a first screw hole; a driver pin attached to afirst end of the plate; an implant pin attached to a second end of theplate, wherein the driver pin and implant pin are substantiallycolinear, and wherein the diameter of the driver pin is greater than thediameter of the implant pin.

Various embodiments are described, wherein the plate has a second screwhole.

Various embodiments of a method of inserting the K-wire are described,including: reducing a bone fragment to a native bone; driving the K-wirethrough the bone fragment into the native bone; backing the K-wire outof the bone; bending the K-wire to conform to the native bone so thatplate is flush to the native bone; pushing the bent K-wire back into thebone; cutting off the driver pin; and inserting a screw in the screwhole to secure the plate and the K-wire to the native bone.

Further various embodiments relate to a K-wire with an integrated plate,including: a plate with a first screw hole; and two implant pinsattached to a second end of the plate, wherein in the two implant pinsare substantially parallel.

Various embodiments are described, wherein the plate has a second screwhole.

Various embodiments of a method for inserting the K-wire are described,including: reducing a bone fragment to a native bone; drilling two holesthrough the bone fragment into the native bone; driving the K-wire intothe two holes backing the K-wire out of the bone; bending the K-wire toconform to the native bone so that plate is flush to the native bone;pushing the bent K-wire back into the bone; and inserting a screw in thescrew hole to secure the plate and the K-wire to the native bone.

Various embodiments are described, wherein the two implant pins aredifferent lengths.

Various embodiments of a method of inserting a K-wire are described,including: reducing a bone fragment to a native bone; drilling a firsthole through the bone fragment into the native bone with a genericK-wire; drilling a second hole through the bone fragment into the nativebone with the generic K-wire; driving the longer implant pin into thefirst hole to engage the native bone; removing the generic K-wire fromthe second hole; aligning the shorter implant pin with the second hole;inserting the shorter implant pin in the second hole; backing the K-wireout of the bone; bending the K-wire to conform to the native bone sothat plate is flush to the native bone; push the bent K-wire back intothe bone; and insert a screw in the screw hole to secure the plate andthe K-wire to the native bone.

Further various embodiments relate to a donut washer configured tosecure a K-wire to a native bone, including: a washer portion includinga screw hole wall configured to form a screw hole; a rim along a lowersurface of the washer portion configured to extend around a portion ofthe circumference of the washer portion; and a channel configured toengage the K-wire between the rim and the screw hole wall.

Various embodiments are described of a method for implanting a K-wireusing the donut washer, including: reducing a bone fragment to a nativebone; driving the K-wire through the bone fragment into the native bone;backing the K-wire out of the bone; bending the K-wire to conform to thenative bone so that plate is flush to the native bone; pushing the bentK-wire back into the bone; selecting a location to secure the K-wire tothe native bone; bending the K-wire at a location corresponding to thelocation selected on the native bone, wherein the bend in the K-wireconforms to the channel; cutting off the excess length of the K-wire;placing the donut washer over the cut K-wire; and inserting a screw inthe screw hole to secure the donut washer and the K-wire to the nativebone.

Further various embodiments relate to a screw with a channel configuredto secure a K-wire to a native bone, including: a shank; a headconnected to the shank; a rim on a lower surface of the head; and achannel on the lower surface of the head between the rim and the shankconfigured to engage the K-wire.

Various embodiments of a method for implanting a K-wire using the screware described, including: reducing a bone fragment to a native bone;driving the K-wire through the bone fragment into the native bone;backing the K-wire out of the bone; bending the K-wire to conform to thenative bone so that plate is flush to the native bone; pushing the bentK-wire back into the bone; selecting a location to secure the K-wire tothe native bone; bending the K-wire at a location corresponding to thelocation selected on the native bone, where the bend in the K-wireconforms to the channel; cutting off excess length of the K-wire;drilling hole at the selected location; placing the shank through thebent portion of the cut K-wire; and tightening the screw in the screwhole to secure the K-wire to the native bone.

Further various embodiments relate to a slotted washer configured tosecure a K-wire to a native bone, including: a upper arm with a screwhole; a lower arm with a screw hole; a connector connecting the upperarm with the lower arm; and a K-wire opening between the connector,lower arm, and upper arm configured to receive and compress the K-wire.

Various embodiments are described, further including a window adjacentthe K-wire opening configured to provide a view of the K-wire duringinsertion into the K-wire opening.

Various embodiments of a method for implanting a K-wire using theslotted washer are described, including: reducing a bone fragment to anative bone; driving the K-wire through the bone fragment into thenative bone; backing the K-wire out of the bone; bending the K-wire toconform to the native bone so that plate is flush to the native bone;pushing the bent K-wire back into the bone; selecting a location tosecure the K-wire to the native bone; cutting off an excess length ofthe K-wire; placing the slotted washer over the cut K-wire; andinserting a screw in the screw hole to secure the donut washer and theK-wire to the native bone.

BRIEF DESCRIPTION OF THE DRAWINGS

In order to better understand various exemplary embodiments, referenceis made to the accompanying drawings, wherein:

FIGS. 1A, 1B, 1C, 1D, and 1E illustrate perspective, top, side, end, andcross-sectional (through the plate) views respectively of a firstembodiment of a K-wire with an integrated plate;

FIGS. 2A, 2B, 2C, 2D, and 2E illustrate perspective, top, side, end, andcross-sectional (through the plate) views respectively of a secondembodiment of a K-wire with an integrated plate;

FIGS. 3A, 3B, 3C, 3D, and 3E illustrate perspective, top, side, end, andcross-sectional (through the plate) views respectively of a thirdembodiment of a K-wire with an integrated plate;

FIGS. 4A, 4B, 4C, 4D, and 4E illustrate perspective, top, side, end, andcross-sectional (through the plate) views respectively of a fourthembodiment of a K-wire with an integrated plate;

FIGS. 5A, 5B, 5C, 5D, and 5E illustrated top perspective, bottomperspective, top, cross-sectional, and side views respectively of adonut shaped washer;

FIGS. 6A, 6B, 6C, 6D, and 6E illustrated top perspective, bottomperspective, side, cross-sectional, and top views of a screw with achannel; and

FIGS. 7A, 7B, 7C, and 7D illustrate perspective, top, side, andcross-sectional views of a slotted washer; and

FIG. 7E illustrates a perspective view of another embodiment of theslotted washer without a window.

To facilitate understanding, identical reference numerals have been usedto designate elements having substantially the same or similar structureand/or substantially the same or similar function.

DETAILED DESCRIPTION

The description and drawings illustrate the principles of the invention.It will thus be appreciated that those skilled in the art will be ableto devise various arrangements that, although not explicitly describedor shown herein, embody the principles of the invention and are includedwithin its scope. Furthermore, all examples recited herein areprincipally intended expressly to be for pedagogical purposes to aid thereader in understanding the principles of the invention and the conceptscontributed by the inventor(s) to furthering the art and are to beconstrued as being without limitation to such specifically recitedexamples and conditions. Additionally, the term, “or,” as used herein,refers to a non-exclusive or (i.e., and/or), unless otherwise indicated(e.g., “or else” or “or in the alternative”). Also, the variousembodiments described herein are not necessarily mutually exclusive, assome embodiments can be combined with one or more other embodiments toform new embodiments.

Dorsal and volar rim fractures of the distal radius are difficult tofix, because they include small fragments and have fragment displacingforces from the wrist (bone and ligamentous) acting on the fragments.These fractures must be fixed to prevent ongoing dislocation of thewrist. K-wires have been used to capture and fix these fractures bysurgeons. For example after the fracture has been reduced, the surgeonmay drive a K-wire into the bone fragment using a driver. The K-wire maythen be bent down along the bone long axis and then secured to the boneusing for example a plate.

Various new implants will be described herein that will easeimplantation and reliably fix the K-wires. First, four differentembodiments of K-wire with an integrated plate structure will bedescribed. Next a donut shaped washer for capturing and securing theK-wire is disclosed. Further, a screw with a channel is disclosed thathas a head shaped to capture and secure the K-wire. Finally, embodimentsof a slotted washer are disclosed that captures and secures the K-wire.While these embodiments are described for use with volar rim factures,the embodiments may be adapted and used in various other locations andapplications.

FIGS. 1A, 1B, 1C, 1D, and 1E illustrate perspective, top, side, end, andcross-sectional (through the plate) views respectively of a firstembodiment of a K-wire with an integrated plate. The K-wire 100 mayinclude a driver pin 104, an implant pin 110, and a plate 102. Thedriver pin 104 has a length sufficient to enable a driver to engage thedriver pin 104 as well as to allow it to be used to help bend the K-wire100 into position. The diameter of the driver pin 104 may be greaterthan the diameter of the implant pin 110, but in some embodiments theymay have the same diameter. In some examples, the diameters driver pin104 and implant pin 100 may respectively be 1.6 mm and 1.2 mm, 2.0 mmand 1.6 mm, or 2.0 and 1.2 mm. This difference may help to clearlydifferentiate between the driver pin 104 and the implant pin 110 duringuse. Also, the increased diameter of the driving portion 104 may improvestability when the K-wire 100 is driven into the bone. Also the diameterof the driving portion may be selected to be the same or less than thethickness of the plate 102 so that the K-wire has as low profile aspossible.

The implant pin 110 may have a distal end 114 that is sharp, pointed,and/or chiseled so that it can be driven into the bone when rotated bythe driver. As discussed above the diameter of the implant pin 110 maybe smaller than the diameter of the driver pin 104. The diameter will besufficient to provide the structural strength and integrity for theimplant pin 110 to hold the fractured bone in place, but also to be ableto be bent into a desired shape to be secured to the bone. The driverpin 104 and the implant pin 110 are substantially colinear to allow theK-wire 100 to be driving into the bone.

The plate 102 is attached between the driver pin 104 and the implant pin110. The plate 102 is shown as round, but may take on other shapes aswell. The plate 102 has a screw hole 106 configured to receive a screwto secure the plate 102 to the bone. Further, the hole 106 may have afrustoconical shaped rim 108 that is configured to mate with the head ofthe screw used to secure the plate 102 to the bone. This rim 108facilitates a more secure fixation to the bone as well as leading to alower profile installation as the screw head may be below the upper edgeof the rim 108.

FIGS. 2A, 2B, 2C, 2D, and 2E illustrate perspective, top, side, end, andcross-sectional (through the plate) views respectively of a secondembodiment of a K-wire with an integrated plate. The K-wire 200 mayinclude a driver pin 204, an implant pin 210, and a plate 202. Thedriver pin 204 has a length sufficient to enable a driver to engage thedriver pin 204 as well as to allow it to be used to help bend the K-wire200 into position. The diameter of the driver pin 204 may be greaterthan the diameter of the implant pin 210. In some examples, thediameters may be 1.6 mm and 1.2 mm, 2.0 mm and 1.6 mm, or 2.0 and 1.2mm. This difference may help clearly differentiate between the driverpin 204 and the implant pin 210 during use. Also, the increased diameterof the driving portion 204 may improve stability when the K-wire 200 isdriven into the bone. Also the diameter of the driving portion may beselected to be the same or less than the thickness of the plate 202 sothat the K-wire has as low profile as possible.

The implant pin 210 may have a distal end 214 that is sharp, pointed,and/or chiseled so that it can be driven into the bone when rotated bythe driver. As discussed above the diameter of the implant pin 210 maybe smaller than the diameter of the driver pin 204. The diameter will besufficient to provide the structural strength and integrity for theimplant pin 210 to hold the fractured bone in place, but also to be ableto be bent into a desired shape to be secured to the bone.

The plate 202 is attached between the driver pin 204 and the implant pin210. The plate 202 is shown as generally rectangular, but may take onother shapes as well. The plate 202 has two screw holes 206 and 207configured to receive screws to secure the plate 202 to the bone.Further, the holes 206, 207 may have frustoconical shaped rims 208, 209that are configured to mate with the head of the screw used to securethe plate 202 to the bone. These rims 208, 209 facilitate a more securefixation to the bone as well as leading to a lower profile installationas the screw head may be below the upper edge of the rims 208, 209. Thedriver pin 204 and the implant pin 210 are substantially colinear toallow the K-wire 200 to be driven into the bone.

A method for using the K-wires 100, 200 will now be described. First,the bone fragment is reduced to the native bone. The K-wire 100, 200 isthen attached to a driver, and the K-wire 100, 200 is driven through thebone fragment into the native bone. Then the K-wire 100, 200 may bebacked out of the bone, for example by 5-10 mm. The K-wire 100, 200 isthen bent to conform to the native bone so that the plate 102, 202 isflush to the native bone. Next, the bent K-wire 100, 200 is pushed backinto the bone to be flush with the bone. The driver pin 104, 204 maythen be cut off. Finally, a screw(s) is inserted into the plate 102, 202to fix the plate 102, 202 and the K-wire 100, 200 to the bone.

FIGS. 3A, 3B, 3C, 3D, and 3E illustrate perspective, top, side, end, andcross-sectional (through the plate) views respectively of a thirdembodiment of a K-wire with an integrated plate. The K-wire 300 mayinclude a driver tab 304, implant pins 310, 312, and a plate 302. Thedriver tab 304 has a length sufficient to enable a driver to engage thedriver tab 304 as well as to allow it to be used to help bend the K-wire300 into position. In alternative embodiments, the K-wire 300 may notinclude driver tab 304, but instead a driver may engage the plate 302directly for insertion.

The implant pins 310, 312 may have distal ends 314, 316 that are sharp,pointed, and/or chiseled so that they can be driven into the bone. Thediameter of the implant pins 310, 312 will be sufficient to provide thestructural strength and integrity for the implant pins 310, 312 to holdthe fractured bone in place, but also to be able to be bent into adesired shape to be secured to the bone. In some embodiments, theimplant pins 314, 316 may be of different lengths that may facilitateimplanting the K-wire 300.

The plate 302 is attached between the driver tab 304 and the implantpins 310, 312. The plate 302 is shown as generally rectangular, but maytake on other shapes as well. The plate 302 has a screw hole 306configured to receive a screw to secure the plate 302 to the bone.Further, the hole 306 may have a frustoconical shaped rim 308 that isconfigured to mate with the head of the screw used to secure the plate302 to the bone. This rim 308 facilitates a more secure fixation to thebone as well as leading to a lower profile installation as the screwhead may be below the upper edge of the rim 308. The plate 302 isdesigned to be as low profile as possible.

FIGS. 4A, 4B, 4C, 4D, and 4E illustrate perspective, top, side, end, andcross-sectional (through the plate) views respectively of a fourthembodiment of a K-wire with an integrated plate. The K-wire 400 mayinclude a driver tab 404, implant pins 410, 412, and a plate 402. Thedriver tab 404 has a length sufficient to enable a driver to engage thedriver tab 404 as well as to allow it to be used to help bend the K-wire400 into position. In alternative embodiments, the K-wire 400 may notinclude driver tab 404, but instead a driver may engage the plate 402directly for insertion.

The implant pins 410, 412 may have distal ends 414, 416 that are sharp,pointed, and/or chiseled so that they can be driven into the bone. Thediameter of the implant pins 410, 412 will be sufficient to provide thestructural strength and integrity for the implant pins 410, 412 to holdthe fractured bone in place, but also to be able to be bent into adesired shape to be secured to the bone. In some embodiments, theimplant pins 414, 416 may be of different lengths that may facilitateimplanting the K-wire 400.

The plate 402 is attached between the driver tab 404 and the implantpins 410, 412. The plate 402 is shown as generally rectangular, but maytake on other shapes as well. The plate 402 has a screw holes 406, 407configured to receive screws to secure the plate 402 to the bone.Further, the holes 406, 407 may have frustoconical shaped rims 408, 409that are configured to mate with the head of the screw used to securethe plate 402 to the bone. These rims 408, 409 facilitate a more securefixation to the bone as well as leading to a lower profile installationas the screw head may be below the upper edge of the rims 408, 409. Theplate 402 is designed to be as low profile as possible.

It is noted that in some situations while using the K-wires 100, 200 thebone fragment may rotate because of a single implant pin 112, 212. TheK-wires 300, 400 use two implant pins which will prevent the rotation ofthe bone fragment when the K-wires 300, 400 are used.

A method for using the K-wires 300, 400 will now be described. First,the bone fragment is reduced to the native bone. Next, two holes aredrilled through the bone fragment into the native bone. This may be doneusing a regular K-wire or using a bone drill bit. The K-wire 300, 400 isthen attached to a driver via either the driver tab 304, 404 or theplate 302, 402, and the K-wire 300, 400 is driven through the holes inbone fragment into the holes in the native bone. Then the K-wire 300,400 may be backed out of the bone, for example by 5-10 mm. The K-wire300, 400 is then bent to conform to the native bone so that the plate302, 402 is flush to the native bone. Next, the bent K-wire 300, 400 ispushed back into the bone to be flush with the bone. The driver tab 304,404 (if present) may then be cut off. Finally, a screw(s) is insertedinto the plate 302, 402 to fix the plate 302, 402 and the K-wire 300,400 to the bone.

A method for using the K-wires 300, 400 where the implantation pins areof different lengths will now be described. First, the bone fragment isreduced to the native bone. Next, two holes a drilled through the bonefragment into the native bone using regular K-wires. The K-wire 300, 400is then attached to a driver via either the driver tab 304, 404 or theplate 302, 402. Then one of the regular K-wires is removed, and thelonger implant pin is inserted into the hole. The additional length ofthe longer implant pin may be sufficient to extend into the native bone.Then the second regular K-wire is removed, and the K-wire 300, 400 isrotated so that the shorter implant pin aligns with the second hole, andthen the shorter implant pin and hence the whole K-wire 300, 400 isdriven into the bone fragment and the native bone. Then the K-wire 300,400 may be backed out of the bone, for example by 5-10 mm. The K-wire300, 400 is then bent to conform to the native bone so that the plate302, 402 is flush to the native bone. Next, the bent K-wire 300, 400 ispushed back into the bone to be flush with the bone. The driver tab 304,404 (if present) may then be cut off. Finally, a screw(s) is insertedinto the plate 302, 402 to fix the plate 302, 402 and the K-wire 300,400 to the bone. This approach allows for the bone fragment to remainsecurely in place at all times by at least one K-wire/implant pin.

This procedure may also use a single regular K-wire that is used todrill a first hole and then is used to drill the second hole and is leftin place. Then the longer implant pin may be placed in the first holeand the procedure is then carried out as described above.

The K-wire embodiments described above may be used in a variety ofapplications and locations. The K-wires would be sized based upon thespecific application and location. Further, because of the small areataken up by the plates, they leave ample area for other implants to beplaced as needed to repair a bone fracture.

Various types of screws may be used with the K-wires embodiments includelocking and variable angle screws if the application requires suchscrews. Accordingly, the screw holes would be modified to accommodatethese other types of screws.

FIGS. 5A, 5B, 5C, 5D, and 5E illustrated top perspective, bottomperspective, top, cross-sectional, and side views respectively of adonut shaped washer. The donut shaped washer 500 includes an screw hole504 and frustoconical rim 506 that are configured to accept a screw. Thescrew hole 504 is surrounded by a wall 510. The donut shaped washer 500includes a rim 502 that extends from a lower surface 516 of the donutwasher. The rim 502 extends around portion of the circumference of thedonut washer 500. The rim 502 has an inner wall 514. The inner wall 514of the rim 502, the wall 510, and the lower surface 516 form a channel512. When the donut washer 500 is attached to a bone, an opening 508 isformed between the donut washer 500 and the bone. This opening willallow a K-wire to extend under the donut washer 500 into the channel512.

The donut shaped washer 500 may be used to secure a K-wire to a bone.First, the bone fragment is reduced to the native bone. The K-wire isthen attached to a driver, and the K-wire is driven through the bonefragment into the native bone. Then the K-wire may be backed out of thebone, for example by 5-10 mm. The K-wire is then bent to conform to thenative bone. Next, a location for securing the K-wire to the native boneis selected. A tool may then be used to bend the K-wire at a locationcorresponding the location selected on the native bone. The tool bendsthe K-wire into a shape that corresponds to the channel 512 in the donutwasher 500. The excess length of the bent K-wire may then be cut off sothat the end of cut K-wire is in the channel 512 or at least under thelower surface 516. This will prevent a sharp end of the cut K-wire fromcausing soft tissue irritation to the patient. Then the donut washer 500is placed over the cut K-wire, and a screw is placed through the screwhole 504 to compress the donut washer 500 and K-wire to the bone. TheK-wire enters through the opening 508 and wraps around the donut washer500.

FIGS. 6A, 6B, 6C, 6D, and 6E illustrated top perspective, bottomperspective, side, cross-sectional, and top views of a screw with achannel. The screw 600 includes a head 602 and a shank 606. The shank606 has threads 608 and a distal end 610.

The head may include a drive 604 which in this example is star-shaped,but may take on other shapes as well. The underside of the head 602includes a channel 614. The channel 614 is formed between a ridge 612and the shank 606. The channel 614 is configured to capture and secure aK-wire.

The screw with a channel 600 may be used to secure a K-wire to a bone.First, the bone fragment is reduced to the native bone. The K-wire isthen attached to a driver, and the K-wire is driven through the bonefragment into the native bone. Then the K-wire may be backed out of thebone, for example by 5-10 mm. The K-wire is then bent to conform to thenative bone. Next, a location for securing the K-wire to the native boneis selected. A tool may then be used to bend the K-wire at a locationcorresponding the location selected on the native bone. The tool bendsthe K-wire into a shape that corresponds to the channel 614 in the screw600. The excess length of the bent K-wire may then be cut off so thatthe end of cut K-wire is in the channel 614. This will prevent a sharpend of the cut K-wire from causing soft tissue irritation to thepatient. Then a hole may be drilled for the screw 600. The screw 600 maythen be placed the through the bend in the K-wire and the screwtightened to compress the K-wire to the bone. The K-wire is mostlycompressed to the bone by the channel 614 except where the K-wire passesunder the rim 612 into the channel 614. The use of the channel 614allows for the screw 600 to secure the K-wire to the native bone with alower profile, because with the K-wire in the channel 614 the top of thehead of screw may be tightened to be closer to the bone than without thechannel. Further, compression of the bone surface may occur where theK-wire contacts the bone under the screw head 602, but this compressionis minimized to just the point where the K-wire passes under the rim612. One benefit of the screw 600 for securing a K-wire is that it is asingle part leading to a less complicated insertion of the K-wire.

FIGS. 7A, 7B, 7C, and 7D illustrate perspective, top, side, andcross-sectional views of a slotted washer. The slotted washer 700 has afolded structure with an upper leg 710 and a lower leg 712. A connector702 at an edge of the slotted washer 700 connects the upper leg 710 tothe lower leg 712. There is a gap 714 between the upper leg 710 and thelower leg 712. The slotted washer 700 also includes a K-wire opening 708adjacent the connector 702. The K-wire opening may be somewhatcylindrical in shape and is configured to receive an end of the K-wiretherethrough. The upper leg 710 and lower leg 712 may have a screw hole704. Further, the upper leg 710 may include a frustoconical shaped rim706 that is configured to mate with the head of the screw used to securethe slotted washer 700 the bone. In some embodiments this rim 706 mayextend into the lower arm 712 as well. The slotted washer 700 includes awindow 716. The window 716 allows for the surgeon to see the location ofthe end of the K-wire through the K-wire opening 708.

FIG. 7E illustrates a perspective view of another embodiment of theslotted washer 700 without a window.

The slotted washer 700 may be used to secure a K-wire to a bone. First,the bone fragment is reduced to the native bone. The K-wire is thenattached to a driver, and the K-wire is driven through the bone fragmentinto the native bone. Then the K-wire may be backed out of the bone, forexample by 5-10 mm. The K-wire is then bent to conform to the nativebone. Next, a location for securing the K-wire to the native bone isselected. The excess length of the bent K-wire may then be cut off sothat the end of cut K-wire ends up within the K-wire opening 708. Thiswill prevent a sharp end of the cut K-wire from causing soft tissueirritation to the patient. Then the K-wire opening 708 of the slottedwasher 700 is slid over the cut K-wire and a screw is placed through thescrew hole 704 to compress the upper arm 710 towards the lower arm 712which compresses and secures the K-wire in the K-wire opening 708. Thescrew also secures the slotted washer 700 and the K-wire to the bone. Inthe second embodiment of the slotted washer 700 of FIG. 7E, the surgeonmay view the cut end of the K-wire as it passes through the window 716to verify the location of the cut end of the K-wire. This ensures thatthe K-wire is inserted far enough into the slotted washer 700 and toensure that the cut end of the K-wire does not stick out of the slottedwasher 700 where it might cause irritation to the patient.

Because the K-wire does not need to be bent with the slotted washer,there is less handling of the K-wire while it being secured to thenative bone. This reduces the possibility that the bone fragments areundesirably displaced or further broken.

The k-wire 100, k-wire 200, donut washer 500, screw 600, and slottedwasher 700 each allow for increased flexibility as to where the K-wireis secured to native bone. Each also provides a low profile solution aswell as taking up a small area on the bone to allow room for otherimplants to be used to treat the fracture as needed.

While each of the embodiments are described above in terms of theirstructural arrangements, it should be appreciated that the inventionalso covers the associated methods of using the embodiments describedabove.

Although the various exemplary embodiments have been described in detailwith particular reference to certain exemplary aspects thereof, itshould be understood that the invention is capable of other embodimentsand its details are capable of modifications in various obviousrespects. As is readily apparent to those skilled in the art, variationsand modifications and combinations of the various embodiments can beaffected while remaining within the spirit and scope of the invention.Accordingly, the foregoing disclosure, description, and figures are forillustrative purposes only and do not in any way limit the invention,which is defined only by the claims.

What is claimed is:
 1. A method for implanting a K-wire wherein theK-wire comprises: a plate with a first screw hole; a driver pin attachedto a first end of the plate; and an implant pin attached to a second endof the plate, wherein the driver pin and implant pin are substantiallycolinear; wherein the method comprises: reducing a bone fragment to anative bone; driving the K-wire through the bone fragment into thenative bone; backing the K-wire out of the bone fragment; bending theK-wire to conform to the native bone so that the plate is flush to thenative bone; pushing the bent K-wire back into the bone fragment;cutting off the driver pin; and inserting a screw in the first screwhole to secure the plate and the K-wire to the native bone.
 2. Themethod of claim 1, wherein the diameter of the driver pin is greaterthan the diameter of the implant pin.
 3. The method of claim 1, whereinthe first screw hole is configured to accept a locking screw.
 4. Themethod of claim 1, wherein the first screw hole is configured to accepta variable angle screw.
 5. The method of claim 1, wherein the plate hasa second screw hole.
 6. A method for implanting a K-wire wherein theK-wire comprises: a plate with a first screw hole; a driver tab attachedto a first end of the plate and two implant pins attached to a secondend of the plate, wherein in the two implant pins are substantiallyparallel; wherein the method comprises: reducing a bone fragment to anative bone; drilling two holes through the bone fragment into thenative bone; driving the K-wire into the two holes backing the K-wireout of the bone fragment; bending the K-wire to conform to the nativebone so that the plate is flush to the native bone; pushing the bentK-wire back into the bone fragment; and inserting a screw in the firstscrew hole to secure the plate and the K-wire to the native bone.
 7. Themethod of claim 6, wherein the first screw hole is configured to accepta locking screw.
 8. The method of claim 6, wherein the first screw holeis configured to accept a variable angle screw.
 9. The method of claim6, wherein the plate has a second screw hole.
 10. A method forimplanting a K-wire wherein the K-wire comprises: a plate with a firstscrew hole; a driver tab attached to a first end of the plate and twoimplant pins attached to a second end of the plate, wherein the twoimplant pins are substantially parallel, and wherein the two implantpins are different lengths; wherein the method comprises: reducing abone fragment to a native bone; drilling a first hole through the bonefragment into the native bone with a generic K-wire; drilling a secondhole through the bone fragment into the native bone with the genericK-wire; driving the longer implant pin into the first hole to engage thenative bone; removing the generic K-wire from the second hole; aligningthe shorter implant pin with the second hole; inserting the shorterimplant pin in the second hole; backing the K-wire out of the bonefragment; bending the K-wire to conform to the native bone so that theplate is flush to the native bone; pushing the bent K-wire back into thebone fragment; and inserting a screw in the first screw hole to securethe plate and the K-wire to the native bone.